PANCREATIC FUNGAL-INFECTIONS - A CASE-REPORT AND REVIEW OF THE LITERATURE

Pancreatic necrosis as a consequence of acute pancreatitis usually imp lies a poor prognosis. Infection is the most common complication affec ting mortality and appears to be increasing. While bacterial infection s, particularly with coliforms, account for the majority of cases of i nfected necrosis, fungal infections are being more frequently document ed. This may be due to increased recognition through improved laborato ry techniques, more aggressive diagnosis by percutaneous aspiration, o r the more widespread use of broad-spectrum antibiotics or parenteral nutrition. While the majority of documented fungal pancreatic infectio ns have been with Candida species, recent reports have highlighted the importance of Torulopsis glabrata. This haploid yeast of the family C ryptococcaceae is a fungal commensal organism accounting for 16% of al l human yeast isolates. Here we report the first case of T. glabrata i nfection complicating pancreatic necrosis and review the current knowl edge of pancreatic fungal infections complicating acute pancreatitis. Superimposed infection, either bacterial or fungal, needs to be dilige ntly sought in patients with pancreatic necrosis who fail to improve o r deteriorate despite supportive care.